Can ERAS help reduce health disparities and overcome barriers to equitable surgical care in marginalized communities?

Chirag Ram , Ruoying Li , Andrew D. Franklin , Kurt Heiss , Carmelle Romain , Irving J. Zamora
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Abstract

Health inequities persist in surgical outcomes between different races and ethnicities. Enhanced Recovery after Surgery (ERAS) protocols are innovative perioperative management strategies that have improved outcomes and reduced costs of delivering care. Quality improvement tools embedded in the protocols allow for sequential improvements in compliance and outcomes. Standardization of perioperative care may reduce healthcare inequities and improve outcomes in marginalized communities. In this review, we describe the benefits of ERAS in surgical outcomes, discuss how implementation of ERAS could potentially reduce health disparities in pediatric surgical patients, demonstrate the barriers present in ERAS implementation, propose solutions to these implementation barriers (Table 1).

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ERAS 能否帮助边缘化社区减少健康差距,克服获得公平外科护理的障碍?
不同种族和族裔之间在手术治疗效果方面仍然存在不平等。术后恢复强化方案(ERAS)是一种创新的围手术期管理策略,可提高疗效并降低护理成本。协议中包含的质量改进工具可持续改善依从性和治疗效果。围手术期护理的标准化可减少医疗保健的不公平现象,改善边缘化社区的治疗效果。在这篇综述中,我们描述了ERAS对手术效果的益处,讨论了ERAS的实施如何可能减少儿科手术患者的健康差异,展示了ERAS实施过程中存在的障碍,并提出了解决这些实施障碍的方法(表1)。
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